In a perfect world, your team creates a dental insurance claim each time an insured patient receives treatment and submits the claim immediately after the patient checks out. And the carrier pays out in a couple of business days. There are not enough emojis to describe what really happens, right? The fact is you need to constantly and consistently monitor your claims process. Dentrix Ascend makes this easier to do by pushing several key pieces of information as the first thing you see every time you log in. As an insurance coordinator, you can use these overview elements as a workflow to get your claims processed and get paid faster.
To use the location Overview page (dashboard) as an insurance coordinator workflow, click each box that provides insight into the status of your insurance claims, and use the information in the page that follows to resolve any problems. These boxes should be reviewed on a daily basis.
- Start your workflow by viewing the list of insured patients who have completed procedures in the Ledger that are not attached to an insurance claim. Click the Unattached Procedures
In the Unattached Procedures page click on the name of each patient in the Patient List in turn. Review the list of procedures; deselect any for which a claim should not be created, and click Create Claim.
- Unsent claims are just that—insurance claims that have been posted to the Ledger but not submitted to the carrier. Sometimes, especially if they are multitasking, people get busy and just forget. Monitoring from the Unsent Claims box helps you find any claims that got missed.
In the Unsent Claims page click on the name of each patient in the Patient List in turn. Review claims for errors before you submit those claims. Click Review/Edit to see claim details and make any edits needed. When the claim is ready to submit, click Send Claim.
- Simply put, unresolved claims are overdue claims. A claim is considered overdue if it was submitted 15 or more days ago and it has either not been paid or was rejected or returned with an error. Click the Unresolved Claims box.
In the Unresolved Claims page click the arrow by a carrier name to expand the list of claims for that carrier. For each claim, review the current status and notes or click Review/Edit to open the Claim Detail panel, which has multiple tabs of information for each claim, and includes a Resubmit button.
Additional Information
- In order to see the insurance widgets on the dashboard, your user role must at minimum include the rights to review insurance. Ask your practice administrator for help to adjust your role definition.
- If your practice has multiple locations, the numbers you see are only for the location you are currently looking at.
- To learn more about claim resolution read Processing Unresolved Claims or watch Processing Unresolved Claims.
- For more information on processing insurance claims watch the Insurance Claims Overview video and then watch the videos in the Insurance Claims course in the Dentrix Ascend Academy.